Healthcare Provider Details

I. General information

NPI: 1245901982
Provider Name (Legal Business Name): STEPHANIE GARCIA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 MALLARD CT
KISSIMMEE FL
34759-4408
US

IV. Provider business mailing address

508 MALLARD CT
KISSIMMEE FL
34759-4408
US

V. Phone/Fax

Practice location:
  • Phone: 863-383-3076
  • Fax:
Mailing address:
  • Phone: 863-383-3076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-181517
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: